Attachment_3_-_Past_Performance_Questionnaire.pdf

ATTACHMENT 3

PAST PERFORMANCE QUESTIONNAIRE

Contractor/Name and Address (City and State):

Contract Number:

Contract Title:

Agency/Entity:

Type of Contract:

Dollar Value:

Contracting Officer Name (federal or other governmental body)/Individual responsible for evaluating the offeror’s performance under the contract:

Telephone Number(s):

Title(s):

Mailing Address:

Period of Performance: From ____________ To ____________. [Insert dates consistent with the period for which past performance information is required to be submitted in accordance with the solicitation.]

Brief Description of Work:

Location of Work: ________________________________________________.

Name, Title, Telephone Number, Organizational Affiliation, Date and Signature of EPA employee filling out this form:

Party Responding to this Query (fill in requested information below)

Name (Party Responding to this Query), Title, Organizational Affiliation, Telephone Number, Mailing Address, and any affiliation with the entity which is the subject of this query and if there is/was an affiliation define what it is/was (fill in requested information below):

1. QUALITY OF PRODUCTS OR SERVICES DELIVERED:

a. Evaluate the contractor’s performance in complying with contract requirements, quality achieved, and overall technical expertise demonstrated. (For example: systematic planning, effective subcontracting, compliance with environmental regulations). Please provide commentary.

Unacceptable Marginal Acceptable Good Outstanding N/A = Not Applicable

Remarks:

b. To what extent were the contractor’s submittals accurate, complete and submitted in a timely manner? (For example: remedial investigation/feasibility study reports, design submittals, project work plans, invoices, health and safety plans, and quality assurance project plans)

Unacceptable Marginal Acceptable Good Outstanding

c. How would you rate the contractor key personnel’s technical expertise and management capabilities?

Unacceptable Marginal Acceptable Good Outstanding

d. How would you rate the contractor personnel’s response to technical direction by the Government?

Unacceptable Marginal Acceptable Good Outstanding N/A = Not Applicable

2. EFFECTIVENESS OF MANAGEMENT:

To what extent was the contractor able to solve contract performance problems, including subcontractor performance problems?

Unacceptable Marginal Acceptable Good Outstanding

3. INITIATIVE IN MEETING CONTRACT REQUIREMENTS:

To what extent did the contractor display initiative in meeting requirements (ex. innovative project solutions)? Please provide commentary.

Unacceptable Marginal Acceptable Good Outstanding

4. TIMELINESS OF PERFORMANCE:

To what extent did the contractor meet project schedules?

Unacceptable Marginal Acceptable Good

5. COST CONTROL:

a. To what extent did the contractor display initiative in controlling overall costs? Please provide commentary.

Acceptable Good Outstanding

b. To what extent was the contractor able to track costs and provide accurate, complete and timely tracking reports? (For example: monthly cost accounting reports, reports of work)

Unacceptable Marginal Acceptable Good Outstanding

c. To what extent were the contractor’s billings current, accurate and complete?

Marginal Acceptable Good Outstanding

6. BUSINESS PRACTICES:

To what extent did the contractor coordinate and cooperate with the Government?

Unacceptable Marginal Acceptable Good Outstanding

7. SMALL DISADVANTAGED BUSINESS PARTICIPATION:

What has been the contractor’s compliance with subcontracting plan goals for small disadvantaged business (SDB) concerns, monetary targets for SDB participation, and the notification requirements (FAR 19.1202-4(b)) for any substitutions of firms that are not SDB concerns?

Unacceptable Marginal Acceptable Good

8. CUSTOMER SATISFACTION:

a. To what extent were you satisfied with the overall performance of the contractor? Please provide commentary.

Acceptable Good Outstanding N/A = Not Applicable

Remarks:

b. Would you do business with the contractor again? If not, why not?

Unacceptable Marginal Acceptable Good Outstanding